March 25, 2014
Multiple Sclerosis Symptoms May Be Treated With Medical Marijuana: AAN
Lawrence LeBlond for redOrbit.com - Your Universe Online
The American Academy of Neurology (AAN) released a new guideline this week that suggests there is little evidence to back up claims that most complementary or alternative medicine (CAM) therapies effectively treat symptoms of multiple sclerosis.
However, one particular type of CAM therapy may help relieve symptoms of spasticity, pain associated with spasticity and frequent urination in patients with MS, said the AAN in its new guideline. This therapy involves use of oral cannabis, medical marijuana pills or medical marijuana spray. The AAN maintained there is not enough evidence to show whether smoking marijuana is helpful in treating MS symptoms.
The new guideline has been published in the March 25, 2014 issue of Neurology, the medical journal of the American Academy of Neurology.
CAM therapies are unconventional therapies that are often used in addition to or in place of doctor-recommended therapies. The guideline looked at these particular CAM therapies, which also included ginkgo biloba, magnetic therapy, bee sting therapy, omega-3 fatty acids and reflexology to determine a connection between the treatment and MS symptom relief.
"Using different CAM therapies is common in 33 to 80 percent of people with MS, particularly those who are female, have higher education levels and report poorer health," said guideline lead author Vijayshree Yadav, MD, with Oregon Health & Science University in Portland and a member of the American Academy of Neurology. "People with MS should let their doctors know what types of these therapies they are taking, or thinking about taking."
Safety is an unknown concern with most CAM therapies and there is currently not enough information to show if most CAM therapies interact negatively with prescription MS drugs. Also, most CAM therapies are not regulated by the FDA. As for marijuana, the FDA has approved synthetic forms of the key ingredients dronabinol and nabilone found in cannabis. These drugs have been approved for treatment of nausea and vomiting associated with chemotherapy that do not respond to standard treatments. Dronabinol is also approved for loss of appetite associated with weight loss in AIDS patients.
Now, there is some evidence that suggests medical marijuana, in pill or oral spray form only, may offer relief of some MS symptoms. While the cannabis therapy can offer relief from frequent urination, it has not been shown to relieve loss of bladder control. The therapy has also not been shown to reduce tremor associated with MS.
The guideline also states that long-term safety of medical marijuana in pill or oral spray is not known, as most studies of the therapy have been relatively short, lasting between six and 15 weeks. Also, medical marijuana in pill or spray form may cause side effects, some of which may be serious. Some of the more common effects are seizures, dizziness, memory problems as well as psychological problems such as depression. A depression-medical marijuana link is of particular concern because it has been previously shown that MS patients are at an increased risk of depression or suicide already.
While most CAM therapies have not shown effectiveness in relieving symptoms associated with MS, the guideline does suggest that ginkgo biloba and magnetic therapies might help reduce tiredness linked to MS. Reflexology may help ease symptoms such as tingling, numbness and other skin sensations.
Between 33 and 80 percent of MS patients use various CAM therapies to treat their symptoms, according to the AAN. However, most of these therapies have no added benefit and some, including bee sting therapy, have potential life-threatening side effects, such as dangers of an allergic reaction.
Timothy Coetzee, of the National MS Society, told HealthDay that the potential of marijuana and its derivatives as a treatment for MS symptoms is an important one.
"I think it really emphasizes our approach to support the rights of people with MS to work with their doctors, recognizing that they need to do this in the context of the legal regulations of the state they're in," said Coetzee, who was not involved in crafting the new guideline.
This guideline is important because it will help inform conversations between people with MS and their physicians about what therapies are most effective in reducing the symptoms of MS, noted Coetzee.
"We're at a place where we need to continue to understand and better appreciate the benefits of what we know and don't know about [alternative medicine]," he told HealthDay’s Maureen Salamon. "I view it as integrated care. It's important we continue to keep our options open so people with MS can live their best lives."